The vasculature: a therapeutic target in heart failure?

Abstract It is well established that the vasculature plays a crucial role in maintaining oxygen and nutrients supply to the heart. Increasing evidence further suggests that the microcirculation has additional roles in supporting a healthy microenvironment. Heart failure is well known to be associate...

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Bibliographic Details
Published in:Cardiovascular research 2022-01, Vol.118 (1), p.53-64
Main Authors: Luxán, Guillermo, Dimmeler, Stefanie
Format: Article
Language:English
Subjects:
Angiogenesis Inducing Agents - adverse effects
Angiogenesis Inducing Agents - therapeutic use
Animals
Coronary Circulation - drug effects
Coronary Vessels - drug effects
Coronary Vessels - metabolism
Coronary Vessels - physiopathology
Genetic Therapy - adverse effects
Heart Failure, Diastolic - genetics
Heart Failure, Diastolic - metabolism
Heart Failure, Diastolic - physiopathology
Heart Failure, Diastolic - therapy
Heart Failure, Systolic - genetics
Heart Failure, Systolic - metabolism
Heart Failure, Systolic - physiopathology
Heart Failure, Systolic - therapy
Humans
Invited Reviews
Microcirculation - drug effects
Microvessels - drug effects
Microvessels - metabolism
Microvessels - physiopathology
Neovascularization, Physiologic - drug effects
Recovery of Function
RNA, Untranslated - genetics
RNA, Untranslated - metabolism
Vaccines - adverse effects
Vaccines - therapeutic use
Ventricular Function, Left - drug effects
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Summary:Abstract It is well established that the vasculature plays a crucial role in maintaining oxygen and nutrients supply to the heart. Increasing evidence further suggests that the microcirculation has additional roles in supporting a healthy microenvironment. Heart failure is well known to be associated with changes and functional impairment of the microvasculature. The specific ablation of protective signals in endothelial cells in experimental models is sufficient to induce heart failure. Therefore, restoring a healthy endothelium and microcirculation may be a valuable therapeutic strategy to treat heart failure. This review article will summarize the current understanding of the vascular contribution to heart failure with reduced or preserved ejection fraction. Novel therapeutic approaches including next generation pro-angiogenic therapies and non-coding RNA therapeutics, as well as the targeting of metabolites or metabolic signalling, vascular inflammation and senescence will be discussed.
ISSN:0008-6363
1755-3245
DOI:10.1093/cvr/cvab047